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A randomized trial of yoga therapy for reflex syncope

Session Top of the pops in arrhythmia treatment - from life-style modification to lead extraction

Speaker Deepak Padmanabhan

Event : ESC Congress 2019

  • Topic : arrhythmias and device therapy
  • Sub-topic : Syncope and Bradycardia - Prevention
  • Session type : Abstract Sessions

Authors : S I Sinam (Bangalore,IN), R S Gangwar (Bangalore,IN), B Banavalikar (Bangalore,IN), D Padmanabhan (Bangalore,IN), V Gangwar (Bangalore,IN), S P Valappil (Bangalore,IN), M K Ghadei (Bangalore,IN), M Ali (Bangalore,IN), J Shenthar (Bangalore,IN)

S.I. Sinam1 , R.S. Gangwar1 , B. Banavalikar1 , D. Padmanabhan1 , V. Gangwar1 , S.P. Valappil1 , M.K. Ghadei1 , M. Ali1 , J. Shenthar1 , 1Sri Jayadeva Institute of Cardiovascular Sciences and Research - Bangalore - India ,

Syncope and Bradycardia - Prevention

European Heart Journal ( 2019 ) 40 ( Supplement ), 3649

Background: Reflex syncope (RS), the most common cause of syncope is usually recurrent, associated with decreased quality of life, and frustrates both the clinicians and the patients with a paucity of effective treatment options.

Purpose: To assess the effectiveness of yoga therapy on the recurrence of reflex syncope.

Methods: Subjects with recurrent RS (>3 episodes) and positive head-up tilt test were enrolled prospectively, and randomized to conventional therapy with physical maneuvres (Group 1) and yoga therapy (Group 2). Group 1 patients were taught physical counter-pressure maneuvers as per guidelines. Group 2 patients were taught yoga for 7 sessions by a certified Yoga instructor/therapist, and then advised to perform yoga for 60 minutes at least five days/week for six months. The Yoga module consisted of Pranayama (breathing techniques), Asanas (Postures) and Dhyana (Meditation) for 60 minutes/session. Both groups were followed up monthly for 6 months in the syncope clinic noting down the recurrences and the quality of life using the syncope functional status questionnaire score.

Result: The study group consisted of 97 patients (group 1: 46 patients and group 2: 51 patients) enrolled prospectively between June 2015 to February 2017. The mean age was 33.1±16.6 years, with male: female ratio 1.1:1, and a mean of 6.4±6.06 syncope episodes (group 1: 6.8±8.0 vs. group 2: 6.0±4.0; p=0.551). The mean duration of symptoms was 17.1±20.71 months (group 1: 16.1±22.8 months vs. group 2: 17.8±19.1 months; p=0.694). There was a significant decrease in the recurrences of syncope in the yoga group compared to the conventional group at three months (group 1: 1.8±1.4 vs group 2: 0.8±0.9, P<0.001) as well as six months follow-up (group 1: 3.38±3.0 vs group 2: 0.98±1.23, P<0.001). The quality of life score at 6 months improved in 20 patients in group 1 and in 45 patients in group 2 (<0.001).

Conclusion: Guided yoga therapy is superior to conventional measures in reducing the number of syncopal episodes and improves the quality of life in patients with reflex syncope. Yoga therapy should be considered as treatment strategy for patients with reflex syncope.

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